title: Clinical findings in oral health during progression of chronic kidney disease to end-stage renal disease in a Swedish population.
abstract: OBJECTIVE
  Early detection of oral infections plays an important role for dental referral during progression of renal disease and during dialysis treatment in uraemic patients. This study investigated how oral health is related to uraemia in a group of uraemic patients in Stockholm, Sweden.
  
  
  METHODS
  This cross-sectional study assessed oral diseases in chronic kidney disease (CKD) patients in different stages (n=93) compared with healthy age- and gender-matched controls. Differences in multiple oral outcomes, assessed by a dentist, were investigated in multivariate analyses, adjusted for tobacco habits, diabetes mellitus and uraemia status (predialysis, peritonealdialysis or haemodialysis).
  
  
  RESULTS
  Compared with healthy controls, uraemic patients had significantly worse dental status regarding the decayed, missing, filled teeth (DMFT) index (3.3, p=0.003), periodontal loss of attachment (0.9, p=0.00002) and periapical lesions (0.6, p=0.002). For haemodialysis patients DMFT (6.5, p=0.01), periodontal loss of attachment (2.2, p=0.007) and periapical lesions (1.0, p=0.01) were worse compared with controls. The differences between uraemic patients and controls remained after adjustment for age, gender, tobacco habits and diabetes (p<0.05 for all outcomes).
  
  
  CONCLUSIONS
  Objective measurements showed that uraemic patients have more dental problems than healthy controls and the patients seem to develop their problems before they have progressed to dialysis. Therefore greater attention to dental problems may be warranted during the progression of uraemia to prevent deterioration of oral health.
authors.affiliation: Department of Dental Medicine, Public Dental Service and Renal Medicine, Karolinska University Hospital, Stockholm, Sweden. royne.thorman@ki.se
authors.forename: Royne
authors.initials: R
authors.lastname: Thorman
authors.forename: Martin
authors.initials: M
authors.lastname: Neovius
authors.forename: Britta
authors.initials: B
authors.lastname: Hylander
mesh_terms: D003430:Cross-Sectional Studies; D018450:Disease Progression; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D015999:Multivariate Analysis; D009909:Oral Health; D010510:Periodontal Diseases / Q000453:epidemiology / Q000209:etiology; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D013548:Sweden; D014075:Tooth Discoloration / Q000453:epidemiology / Q000209:etiology